The forefoot extends anteriorly from the tarsometatarsal (Lisfranc) joint.  It consists of the five metatarsals and five phalanges.  The first three tarsometatarsal joints have little motion due to “tight” articulations and strong ligamentous connections.  These articulations and the Roman Arch configuration of the proximal second metatarsal is responsible for forming and maintaining the transverse arch of the foot.  The fourth and fifth metatarsals heads have more motion at the Lisfranc joint to aid in balance.  The plantar aspect of the first and fifth metatarsals make up the medial and lateral legs of the weight bearing “tripod”.     

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